Anoscopes are known that comprise a cylindrical or a cylindrical-conical body, which body is provided with a handle that can be handled by an operator and which can be inserted, through the anal opening, in the terminal tract of the rectum of a patient. The body of the anoscope is hollow, it is opened at the opposite sides and arranged for receiving a dilator. The dilator is cylinder-shaped, it has an ogival or rounded distal end protruding outwardly from the distal end of the body of the anoscope and it acts (when the anoscope is inserted in the rectum) by stretching the muscular wall of the rectum without damaging the mucosa of the latter. In use, after inserting the anoscope, the dilator is extracted and the body remains in place, thus dilating temporarily the lumen of the terminal tract of the rectum and allowing to insert suitable instruments (hemorrhoidal ligators, suture needles-holders, clamps, etc.) to carry out diagnostic and/or surgical manoeuvres. According to the type of anoscope, the portion of intestinal mucosa to be examined and/or treated surgically is made accessible to the operator (surgeon) through the distal end of the body (which can have a truncated end or be bevelled) or through one or more so called operating windows, namely incisions obtained on the side wall of the body.
A drawback of the above disclosed anoscopes is that, in order to light effectively the operating field, namely the zone of rectal mucosa to be treated surgically (for example to occlude an arterial branch afferent to a hemorrhoid), it is necessary to use a suitable lighting device. The latter can for example be a flexible cable made of optical fibre associated to an external source of light. Therefore, the operator has to remove the dilator from the body of the anoscope and insert the lighting device inside the cavity of the latter. Once inserted, the lighting device has to remain in place (namely, inside the cavity of the body of the anoscope) substantially for all the time necessary to complete the surgical intervention. However, the encumbrance inevitably produced by the lighting device substantially interferes with the actions to be performed in the operating field, making it more uncomfortable for the operator to carry out the intervention. In addition, the intervention time tends to protract, as the operator must prearrange a suitable lighting of the operating field before starting the intervention, and this makes the execution of the intervention more uncomfortable for the patient too.
A further drawback of the above disclosed anoscopes is found when the operator must use a surgical instrument in the operating field. In this case, in fact, the operator is forced to position into the cavity of the anoscope, near the operating field, both the lighting device and the surgical instrument. Consequently, the accessibility of the operating field is significantly reduced due to the overall encumbrance produced by the surgical instrument and by the lighting device. Moreover, the operator is forced to manage manually a plurality of devices (anoscope, surgical instrument, lighting device) in a substantially contemporaneous manner. All this contributes to make it further uncomfortable to carry out a surgical intervention on the rectal mucosa of a patient.
A further and more general drawback of the above disclosed anoscopes is caused by the presence of the dilator. Although the latter is an essential component of the anoscope (since it enables the muscular wall of the rectum to be stretched without damaging the mucosa thereof), it is however an element which interferes with the accessibility of the operating field and which has to be removed, in use, by the operator in order to freely enter the inner cavity of the anoscope. However, in order to insert and extract the dilator, the operator is forced to carry out a number of manoeuvres substantially protracting the time of the surgical intervention, making the latter more complex for the operator and more uncomfortable for the patient.
The drawbacks connected to the methods that are ordinarily used to treat hemorrhoids in patients must be added to the above disclosed drawbacks that are related to the structure of known anoscopes. In the field of the proctological surgery, the treatment of hemorrhoids, namely of the hemorrhoidal disease, is usually carried out by removing the hemorrhoidal cushions or nodules (so called hemorrhoidectomy) or repositioning the hemorrhoidal nodules in the respective anatomic seat (so called hemorrhoidopexy). The hemorrhoidopexy, although being less bloody and invasive than hemorrhoidectomy, requires however to cut the patient's tissues. The hemorrhoidopexy in fact provides for a correction of the mucosal prolapse and a consequent repositioning of hemorrhoids by applying suturing stitches. The hemorrhoidopexy, like hemorrhoidectomy, causes post-operative pain and requires a post-operative control of the patient.
In the field of the proctological surgery, and in particular in the field of the surgical treatment of the hemorrhoidal disease, it is thus significantly perceived the need for instruments, in particular anoscopes, and methods to treat hemorrhoids in the patients enabling the various above disclosed prior art drawbacks to be overcome.